Active NPI
Sloan Michael Osborn, RD, LDN
- Registered Dietitian
- Carpentersville, IL
National Provider Identifier
1225666001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164006957
- Practice address
- 2063 Limestone LN
Carpentersville, IL 60110-1239 - Phone
- (708) 606-6969
- NPI assigned
- Mar 29, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164006957 | IL | Primary |
Addresses
Primary practice location
2063 Limestone LN
Carpentersville, IL 60110-1239
Mailing address
2063 Limestone LN
Carpentersville, IL 60110-1239
Phone (708) 606-6969
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164006957 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585440000000",
"number": "1225666001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2063 LIMESTONE LN",
"city": "CARPENTERSVILLE",
"state": "IL",
"postal_code": "601101239",
"telephone_number": "708-606-6969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2063 LIMESTONE LN",
"city": "CARPENTERSVILLE",
"state": "IL",
"postal_code": "601101239",
"telephone_number": "708-606-6969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSBORN",
"first_name": "SLOAN",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "RD, LDN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-03-29",
"last_updated": "2020-03-29",
"certification_date": "2020-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164006957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carpentersville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.